House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study

LLIN evaluation in Uganda project (LLINEUP2): association between housing construction and malaria burden in 32 districts

BACKGROUND

Well-built housing limits mosquito entry and can reduce malaria transmission. The association between community-level housing and malaria burden in Uganda was assessed using data from randomly selected households near 64 health facilities in 32 districts.

METHODS

Houses were classified as 'improved' (synthetic walls and roofs, eaves closed or absent) or 'less-improved' (all other construction). Associations between housing and parasitaemia were made using mixed effects logistic regression (individual-level) and multivariable fractional response logistic regression (community-level), and between housing and malaria incidence using multivariable Poisson regression.

RESULTS

Between November 2021 and March 2022, 4.893 children aged 2-10 years were enrolled from 3.518 houses; of these, 1.389 (39.5%) were classified as improved. Children living in improved houses had 58% lower odds (adjusted odds ratio = 0.42, 95% CI 0.33-0.53, p < 0.0001) of parasitaemia than children living in less-improved houses. Communities with > 67% of houses improved had a 63% lower parasite prevalence (adjusted prevalence ratio 0.37, 95% CI 0.19-0.70, p < 0.0021) and 60% lower malaria incidence (adjusted incidence rate ratio 0.40, 95% CI 0.36-0.44, p < 0.0001) compared to communities with < 39% of houses improved.

CONCLUSIONS

Improved housing was strongly associated with lower malaria burden across a range of settings in Uganda and should be utilized for malaria control.

Building the vector in: construction practices and the invasion and persistence of Anopheles stephensi in Jigjiga, Ethiopia

Anopheles stephensi is a major vector of malaria in Asia and the Arabian Peninsula, and its recent invasion into Africa poses a major threat to malaria control and elimination efforts on the continent. The mosquito is well adapted to urban environments, and its presence in Africa could potentially lead to an increase in malaria transmission in cities. Most of the knowledge about An stephensi ecology in Africa has been generated from studies conducted during the rainy season, when vectors are most abundant. Here, we provide evidence from the peak of the dry season in the city of Jigjiga in Ethiopia, and report An stephensi immature stages infesting predominantly in water reservoirs made to support construction operations (ie, in construction sites or associated with brick-manufacturing businesses). Political and economic changes in Ethiopia (particularly the Somali Region) have fuelled an unprecedented construction boom since 2018 that, in our opinion, has been instrumental in the establishment, persistence, and propagation of An stephensi via the year-round availability of perennial larval habitats associated with construction. We argue that larval source management during the dry season might provide a unique opportunity for focused control of An stephensi in Jigjiga and similar areas.

Improved household flooring is associated with lower odds of enteric and parasitic infections in low- and middle-income countries: A systematic review and meta-analysis

Enteric and parasitic infections such as soil-transmitted helminths cause considerable mortality and morbidity in low- and middle-income settings. Earthen household floors are common in many of these settings and could serve as a reservoir for enteric and parasitic pathogens, which can easily be transmitted to new hosts through direct or indirect contact. We conducted a systematic review and meta-analysis to establish whether and to what extent improved household floors decrease the odds of enteric and parasitic infections among occupants compared with occupants living in households with unimproved floors. Following the PRISMA guidelines, we comprehensively searched four electronic databases for studies in low- and middle-income settings measuring household flooring as an exposure and self-reported diarrhoea or any type of enteric or intestinal-parasitic infection as an outcome. Metadata from eligible studies were extracted and transposed on to a study database before being imported into the R software platform for analysis. Study quality was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. In total 110 studies were eligible for inclusion in the systematic review, of which 65 were eligible for inclusion in the meta-analysis after applying study quality cut-offs. Random-effects meta-analysis suggested that households with improved floors had 0.75 times (95CI: 0.67-0.83) the odds of infection with any type of enteric or parasitic infection compared with household with unimproved floors. Improved floors gave a pooled protective OR of 0.68 (95CI: 0.58-0.8) for helminthic infections and 0.82 OR (95CI: 0.75-0.9) for bacterial or protozoan infections. Overall study quality was poor and there is an urgent need for high-quality experimental studies investigating this relationship. Nevertheless, this study indicates that household flooring may meaningfully contribute towards a substantial portion of the burden of disease for enteric and parasitic infections in low- and middle-income settings.

Eco-friendly synthesis of Ag-NPs using Endostemon viscosus (Lamiaceae): Antibacterial, antioxidant, larvicidal, photocatalytic dye degradation activity and toxicity in zebrafish embryos

Nanotechnology is a multidisciplinary area of study that has grown significantly in serving many functions and impacting human society. New fields of science have been facilitated by the clean, non-toxic, and biocompatible nature of plant-derived nanoparticles. The present study deals with the first green synthesis of silver nanoparticles (Ag-NPs) using Endostemon viscosus, and their synthesized Ag NPs were characterized by different spectral methods (UV-vis Spectroscopy, Fourier Transform Infrared Spectroscopy (FTIR), X-ray diffraction Spectroscopy (XRD), Transmission Electron Microscopy (TEM) and Energy dispersive X-ray Spectroscopy (EDAX). The change initially observed the production of Ag-NPs in color from green to ash and then confirmed by SPR band at 435 nm in UV-vis spectral analysis. The FTIR findings indicate that many functional groups belong to the pharmaceutically useful phytochemicals, which interact as reducing, capping, and stabilizing agents in synthesizing silver nanoparticles. The predominant peaks in the XRD pattern belong to the planes 210°, 111°, 200°, 241°, and 311° and thus demonstrated the Ag-NPs FCC crystal structure. TEM analysis exhibited spherical-shaped particles with an average size of 13 nm, and the EDAX band showed a distinctive metallic silver peak at 3.0 keV. The antibacterial activity of Ag-NPs tested to show a maximum zone of inhibition of 19 mm for Staphylococcus aureus and 15 mm for Escherichia coli at 100 μg/mL, respectively. Bio-fabricated Ag-NPs were assessed for antioxidant activity (DPPH with % inhibition 57.54% and FRAP with % inhibition 70.89%). The biosynthesized Ag-NPs demonstrated potential larvicidal efficacy against Aedes aegypti with more than 90% at 250 μg/mL. Histological profiles were altered while treating with Ag-NPs at 250 μg/mL. The photocatalytic activity of synthesized E. viscosus Ag-NPs was tested against methylene blue (MB) and crystal violet (CV), and the maximum degradation efficiency was found as 90 and 94%, respectively. Furthermore, the toxicity test on zebrafish embryos demonstrated that aberrations have only been induced at concentrations higher than 500 μg/mL. We conclude that the greenly produced Ag-NPs may find use in biomedical applications based on bacteria and cost-effective industrial wastewater treatment.